Microplastics in dialysis effluent: Environmental chemistry insights and metal-organic frameworks-based remediation prospects

Microplastic (MP) pollution pose serious environmental and public health risks. However, its presence in medical wastewater, specifically in dialysis processes, remains underexplored. The breakdown of polymer materials during dialysis may introduce MPs into the dialysis effluents. Conventional wastewater treatment techniques are insufficient to meet the stringent discharge requirements of MPs, necessitating advanced treatment technologies. We identified 50 peer-reviewed articles (2017–2024) documenting the MPs in dialysis wastewater/effluent and other similar wastewaters and their elimination. The values of MPs in similar effluents fluctuate between 0.2 and 14,000 particles/L, whereas removal efficacies with MOFs are up to 70–99.9% in lab conditions. To the best of our knowledge this review is unique in that it incorporates the sources of MPs in dialysis procedures, the pathways of patient exposure to MPs, and the new application of MOFs in the sustainable removal of MPs. Thus, dialysis effluent should currently be considered a hypothesized but insufficiently investigated source of MPs, rather than a confirmed contributor. Future studies are necessary to directly quantify and characterize MPs in dialysis wastewater to better assess exposure risks.